Evaluation of Long-Term Outcomes of Femoropopliteal Bypass Surgery in Patients With Chronic Limb-Threatening Ischemia in an Endovascular Era

Betz, Thomas; Toepel, Ingolf; Steinbauer, Markus; Zeman, Florian; Uhl, Christian

doi:10.1016/j.avsg.2021.06.046

Cited by 7 publications

(1 citation statement)

References 22 publications

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“…Several standardized options are available for treating ischemic heart and peripheral arterial diseases, such as vascular graft implantation 3 , stent implantation 4 , and drug intervention 5 . Among these, vascular graft implantation using autologous grafts provides high treatment efficacy, better quality of life, and prognosis 6 . Even though autologous vascular grafts are the most suitable for revascularization surgery targeting small arteries, graft preparation is not always ideal because of the poor quality of autologous grafts, possibly associated with comorbidity or previous surgery in the patient 7 , or shortage of preparation time owing to hemodynamic instability during surgery, especially in emergent cases.…”

Section: Introductionmentioning

confidence: 99%

A novel approach for the endothelialization of xenogeneic decellularized vascular tissues by human cells utilizing surface modification and dynamic culture

Kobayashi

Murata

et al. 2022

Sci Rep

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Decellularized xenogeneic vascular grafts can be used in revascularization surgeries. We have developed decellularization methods using high hydrostatic pressure (HHP), which preserves the extracellular structure. Here, we attempted ex vivo endothelialization of HHP-decellularized xenogeneic tissues using human endothelial cells (ECs) to prevent clot formation against human blood. Slices of porcine aortic endothelium were decellularized using HHP and coated with gelatin. Human umbilical vein ECs were directly seeded and cultured under dynamic flow or static conditions for 14 days. Dynamic flow cultures tend to demonstrate higher cell coverage. We then coated the tissues with the E8 fragment of human laminin-411 (hL411), which has high affinity for ECs, and found that Dynamic/hL411showed high area coverage, almost reaching 100% (Dynamic/Gelatin vs Dynamic/hL411; 58.7 ± 11.4 vs 97.5 ± 1.9%, P = 0.0017). Immunostaining revealed sufficient endothelial cell coverage as a single cell layer in Dynamic/hL411. A clot formation assay using human whole blood showed low clot formation in Dynamic/hL411, almost similar to that in the negative control, polytetrafluoroethylene. Surface modification of HHP-decellularized xenogeneic endothelial tissues combined with dynamic culture achieved sufficient ex vivo endothelialization along with prevention of clot formation, indicating their potential for clinical use as vascular grafts in the future.

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